ATLANTA — Republican lawmakers in Georgia would get the final say on whether to expand a government health insurance program for the poor under a bill passed Tuesday, making it even less likely the state will join an overhaul sought by Democratic President Barack Obama.

The election-year legislation came up for a vote in the General Assembly during a busy, second-to-last day of the legislative year. By law, Georgia’s state lawmakers meet for 40 working days. Legislators are in a mad rush to pass their bills because any legislation that does not win approval by the final day Thursday automatically fails for the year.

One of the most significant bills would give Georgia’s Republican-dominated legislature the authority over whether to loosen the rules governing how much money people can make and still qualify for the government-funded Medicaid program. The Democratic health care plan required states to expand their Medicaid programs to include people who are too poor to afford subsidized health insurance but otherwise ineligible for government care.

Instead, the U.S. Supreme Court ruled that states would get to decide whether to expand Medicaid. Republicans like Gov. Nathan Deal have said the long-run costs of an expansion are too expensive. His administration estimates that an expansion would cost Georgia roughly $48 million in the first full year, or less than 1 percent of the proposed state budget. But those costs would rise to nearly $498 million by 2023.

The restriction sought by most Republican lawmakers will likely prove popular with GOP voters during an election year.

“We believe that a decision about an entitlement program should be made by the legislative branch and not an appointed board,” said state Sen. David Shafer, the Republican president pro tempore. “The federal government is trillions of dollars in debt. ... We should be careful about doing our long-term planning based on promises the federal government is making.”

One Democratic lawmaker predicted that Georgia will expand its Medicaid system once the cost of insurance patients becomes too large. The Kaiser Family Foundation has estimated more than 400,000 uninsured people could gain coverage if Georgia expanded its Medicaid system.

“It will be expanded because we have no choice financially,” said state Sen. Nan Orrock, D-Atlanta.

Capitol police arrested 39 protesters on misdemeanor charges of disrupting the legislature after they chanted from the Senate gallery in support of enlarging Medicaid, rallied outside the Senate’s door and held a sit-in at the governor’s office. The Rev. Raphael Warnock, pastor of the Atlanta congregation formerly headed by Martin Luther King Jr., urged politicians to think of the uninsured during a rally that attracted about 100 people.

“They are our neighbors,” said Warnock, who was arrested. “They work in restaurants and cook and wash dishes and provide haircuts... They work at the bedsides sometimes of people who have health care.”

Lawmakers also voted to put in place new restrictions on funding for abortions. Under legislation adopted Tuesday, companies selling health insurance on federally run exchanges and the state employee health plan could not pay for abortions except when a pregnancy threatened the life or health of the mother. Democratic opponents said the bill interfered with a woman’s right to get an abortion and allowed no exceptions for women who are raped.

Taxpayers would borrow $17 million to build a parking deck largely to complement a new Falcons stadium that will be built in Atlanta. That spending was included in a $42.4 state budget adopted by lawmakers Tuesday. It now heads to the governor for approval.

Other measures under consideration would:

• Require drug testing for people receiving food stamps;

• Allow Georgia to adopt a medical marijuana program for patients suffering from some illnesses. The proposal from the House became ensnared in back-and-forth negotiations with the Senate involving a separate proposal to expand insurance coverage for autism.

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